Organization
CHARLES G. CLOUTIER, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNE BOYD (BILLING MANAGER)
(334) 351-2040
Entity
Organization
Contact information
Practice address
461 E MAIN ST, PRATTVILLE, AL 36067-3409
(334) 351-2040
(334) 351-2047
Mailing address
PO BOX 681270, PRATTVILLE, AL 36068-1270
(334) 351-2040
(334) 351-2047
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10751
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB7667
RAILROAD MEDICARE-GROUP
AL
01
—
P00126668
RAILROAD MEDICARE-IND.
AL
Enumeration date
10/29/2007
Last updated
11/05/2007
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